World’s First Epilepsy Treatment Delivers Drug Directly to the Brain

Highlights

• Epilepsy is a neurological disorder which causes seizures. Oral anti-epileptic medications are known to cause side effects such as weight gain and kidney problems.
• The new drug delivery method uses pump technology, which is implanted in the abdomen.
• The pump effectively administers small quantities of the drug directly to the brain without causing side effects.

The world's first epilepsy trial which involves administration of drugs directly to the brain has begun in Australia. Patients with epilepsy are usually administered oral anticonvulsants (anti-seizure) medications. But those medications are known to cause side effects such as weight gain, kidney problems, and loss of bone density.

Direct Administration of Epilepsy Drug to the Brain

The drug trial for epilepsy involves direct delivery of medications to the brain. The trial uses new drug delivery method called the pump technology, which is implanted in the abdomen. The direct administration of medications could help reduce side effects caused by oral anti-epileptic drugs.

Professor Mark Cook, the Director of Neurology at St Vincent's Hospital in Melbourne, who started the drug trial, said, “This is a ‘first in man study’ that holds huge potential for treating other brain diseases such as Parkinson's disease. It won't affect just people with epilepsy potentially, but there are lots of brain diseases that might be better treated by delivering drugs directly to the brain.”

Some form of oral medications must be absorbed into the bloodstream to reach the brain.

“Only small amount of the drug reaches the brain whole body gets soaked in the drug in the meantime,” said Prof Cook.

In the new pump technology, the drugs can be administered directly to where it is needed in smaller quantities.

Groundbreaking Epilepsy Drug Trial on a 27-year-old

A 27-year-old woman named Natalie Kellalea from the Victorian town of Numurkah is the first patient to be implanted with the drug pump.

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Kellalea has tried different combinations of anti-epileptic drugs, but it was unsuccessful, and she became disabled due to severe seizures.

The St Vincent’s Hospital team has implanted the pump in Kellalea’s abdomen which sends anti-epileptic medications.

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The pump sends the drug from the stomach through a tiny tube into the brain cavity where it can diffuse into the areas causing the ‘electrical storm.’

Kellalea had the first medication Epilim through the pump. "She's going very well so far but it's obviously early days," said Prof Cook.

The researchers hope to implant the pump in eight patients to extend the trial. The pump technology can be used to administer more effective drugs that are currently unable to be absorbed by the body.

"We are starting off with drugs that we know and once we finish studying those drugs and have seen how effective they are, we can look at using other newer drugs which at the moment can't be given any other way."

Prof Cook cautioned that the trial is only in its infancy and needs pioneering work. If the trial is a success, patients may not take numerous medications on a daily basis because the pump would only need to be topped up every few months.

Dan Abrams, Chief of Cerebral Therapeutics, said, “This was the first time pumps had been used to deliver medication directly to the brain, in the same way, they had been used to manage­spinal pain and stiffness.”

The pump technology can also be used to treat other conditions such as Parkinson’s disease, Alzheimer’s, stroke and anxiety.

Epilepsy

Epilepsy is a neurological disorder that occurs due to an abnormality in brain wiring, causing seizures. In epilepsy, the disruption of the normal electrochemical activity of the brain causes strange sensations, emotions, muscle spasms, behavior, convulsions and loss of consciousness.

Anti-Epileptic Medications

People with epilepsy are prescribed different combinations of anti-seizure medications to decrease the frequency and intensity of seizures. Around 70% of patients with seizures can be controlled using anti-epileptic medications.

Some of the commonly used drugs for epilepsy include:

• Carbamazepine
• Ethosuximide
• Clobazam
• Phenobarbitone
• Phenytoin
• Sodium valproate

Side effects caused by anti-seizure medications can be mild to severe. Some of the mild side effects of anti-seizure medications are dizziness, fatigue, blurred vision, nausea, skin rashes, memory, and thinking problem. Severe side effects include inflammation of the liver and other organs, depression and suicidal thoughts.

Facts About Epilepsy

• Globally, about 50 million people live with epilepsy
• About 2.4 million people are diagnosed with epilepsy each year
• Epilepsy can affect people of all ages
• Eighty percent of the people with epilepsy live in low-and-middle-income countries
• Idiopathic epilepsy is the most common type of epilepsy which affects 6 out of 10 people with the disorder

References:

1. Epilepsy - (https://medlineplus.gov/epilepsy.html)
2. Guide To Medications For Seizures - (https://www.epilepsy.org.au/sites/default/files/Seizure%20Smart%20-%20Guide%20to%20Medications%20for%20Seizures.pdf)

Source-Medindia